NR 606 MIDTERM EXAM SCRIPT 2026 SOLVED
QUESTIONS WITH FULL SOLUTION
◉ Bipolar disorder medications. Answer: -Lithium
-lamotrigine (Lamictal)
-valproic acid (Depakene)
-Second generation antipsychotics
-carbemazepine (Tegretol)
◉ Bipolar disorder medications: Lithium. Answer: -Lithium
• Action: alters cation transport in the nerve & muscle
• Indication: euphoric mania, rapid cycling, maintenance therapy
• Adverse Effects:
➣GI effects, tremor, polyuria
• Monitor plasma levels
• Use to protect against suicide
,◉ Bipolar disorder medications: lamotrigine (Lamictal). Answer: -
lamotrigine (Lamictal)
• Action: affects sodium channel ion transport & enhances the
activity of y-aminobutyric acid (GABA)
• Indication: maintenance therapy, monotherapy
• Adverse Effects:
➣benign rash (risk for rare Stevens-Johnson Syndrome rash &
multi-organ failure), GI effects, dizziness, h/a
• equal in efficacy to lithium
• Take at bedtime due to sedation side effect
◉ Bipolar disorder medications: valproic acid (Depakene). Answer: -
valproic acid (Depakene)
• Action: affects ion transport and enhances the activity of y-
aminobutyric acid (GABA)
• Indication: acute mania, mixed mood, comorbid substance use,
multiple prior episodes
• Adverse Effects:
➣GI effects, weight gain
• equal to lithium
• Monitor plasma levels
• If using with lamotrigine decrease valporate levels by 50%
,◉ Bipolar disorder medications: Second generation antipsychotics.
Answer: -Second generation antipsychotics
• Action: DA, NE, and 5-HT receptor antagonists
• Indication: acute bipolar depression, acute manic or mixed
episodes, bipolar maintenance/adjunct
• Adverse Effects:
➣weight gain, sedation, GI effects
• Monitor for extrapyramidal effects
• XR form may improve adherence
• injection may improve adherence
◉ Bipolar disorder medications: carbemazepine (Tegretol). Answer:
-carbemazepine (Tegretol)
• Action: glutamate voltage gated sodium & calcium channel blocker
(Glu-CB
• Indication: acute mania, mixed mood
• Adverse Effects:
➣GI effects, sedation, hyponatremia, neutropenia, rash (Stevens-
Johnson Syndrome)
• Monitor plasma levels
• Consider genotyping clients with Asian ancestry
➣HLA-B 2501 allele increases risk of Steven-Johnson Syndrome
, ◉ Maternal mental health disorders (MMHDs). Answer: -Nearly
20% of women experience depression during the perinatal period
(affect 1 in 5 women)
-can occur anytime in the two years between conception and the
first 12 months after childbirth
• symptoms before pregnancy, during, or in first postpartum year
-Maternal suicide
• leading cause of death in postpartum period
• among leading causes of death in pregnancy
-prevalence of perinatal maternal deaths r/t substance abuse is
almost as common as suicide
-Untreated MMHDs can have significant adverse effects on fetal,
neonatal, childhood, & adolescent outcomes
• attachment disorders, cognitive & developmental disorders,
relationship strain
◉ consequences of untreated MMHDs: Impact on the Mother.
Answer: • Have poor nutrition
• Use substances such as alcohol, tobacco, or drugs
• Experience physical, emotional, or sexual abuse
• Be less responsive to baby's cues
• Have fewer positive interactions with baby
• Experience breastfeeding challenges
• Question their competence as mothers
QUESTIONS WITH FULL SOLUTION
◉ Bipolar disorder medications. Answer: -Lithium
-lamotrigine (Lamictal)
-valproic acid (Depakene)
-Second generation antipsychotics
-carbemazepine (Tegretol)
◉ Bipolar disorder medications: Lithium. Answer: -Lithium
• Action: alters cation transport in the nerve & muscle
• Indication: euphoric mania, rapid cycling, maintenance therapy
• Adverse Effects:
➣GI effects, tremor, polyuria
• Monitor plasma levels
• Use to protect against suicide
,◉ Bipolar disorder medications: lamotrigine (Lamictal). Answer: -
lamotrigine (Lamictal)
• Action: affects sodium channel ion transport & enhances the
activity of y-aminobutyric acid (GABA)
• Indication: maintenance therapy, monotherapy
• Adverse Effects:
➣benign rash (risk for rare Stevens-Johnson Syndrome rash &
multi-organ failure), GI effects, dizziness, h/a
• equal in efficacy to lithium
• Take at bedtime due to sedation side effect
◉ Bipolar disorder medications: valproic acid (Depakene). Answer: -
valproic acid (Depakene)
• Action: affects ion transport and enhances the activity of y-
aminobutyric acid (GABA)
• Indication: acute mania, mixed mood, comorbid substance use,
multiple prior episodes
• Adverse Effects:
➣GI effects, weight gain
• equal to lithium
• Monitor plasma levels
• If using with lamotrigine decrease valporate levels by 50%
,◉ Bipolar disorder medications: Second generation antipsychotics.
Answer: -Second generation antipsychotics
• Action: DA, NE, and 5-HT receptor antagonists
• Indication: acute bipolar depression, acute manic or mixed
episodes, bipolar maintenance/adjunct
• Adverse Effects:
➣weight gain, sedation, GI effects
• Monitor for extrapyramidal effects
• XR form may improve adherence
• injection may improve adherence
◉ Bipolar disorder medications: carbemazepine (Tegretol). Answer:
-carbemazepine (Tegretol)
• Action: glutamate voltage gated sodium & calcium channel blocker
(Glu-CB
• Indication: acute mania, mixed mood
• Adverse Effects:
➣GI effects, sedation, hyponatremia, neutropenia, rash (Stevens-
Johnson Syndrome)
• Monitor plasma levels
• Consider genotyping clients with Asian ancestry
➣HLA-B 2501 allele increases risk of Steven-Johnson Syndrome
, ◉ Maternal mental health disorders (MMHDs). Answer: -Nearly
20% of women experience depression during the perinatal period
(affect 1 in 5 women)
-can occur anytime in the two years between conception and the
first 12 months after childbirth
• symptoms before pregnancy, during, or in first postpartum year
-Maternal suicide
• leading cause of death in postpartum period
• among leading causes of death in pregnancy
-prevalence of perinatal maternal deaths r/t substance abuse is
almost as common as suicide
-Untreated MMHDs can have significant adverse effects on fetal,
neonatal, childhood, & adolescent outcomes
• attachment disorders, cognitive & developmental disorders,
relationship strain
◉ consequences of untreated MMHDs: Impact on the Mother.
Answer: • Have poor nutrition
• Use substances such as alcohol, tobacco, or drugs
• Experience physical, emotional, or sexual abuse
• Be less responsive to baby's cues
• Have fewer positive interactions with baby
• Experience breastfeeding challenges
• Question their competence as mothers
